Miglitol improves postprandial endothelial dysfunction in patients with acute coronary syndrome and new-onset postprandial hyperglycemia

Kitano, Daisuke; Chiku, Masaaki; Li, Yuxin; Okumura, Yasuo; Fukamachi, Daisuke; Takayama, Tadateru; Hiro, Takafumi; Saito, Satoshi; Hirayama, Atsushi

doi:10.1186/1475-2840-12-92

Cited by 18 publications

(13 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Monocyte chemoattractant protein −3 (MCP-3), tumor necrosis factor β (TNFβ), epidermal growth factor (EGF), interleukin-10 (Il-10) were significantly decreased posttreatment ( † P ≤ .01; * n = 16, for all other markers n = 17) been previously shown with acute dietary and drug interventions. 15,38,39 Importantly the change in lnRHI we report in this study is comparable to these previous trials with the change in lnRHI we described has been reported as impactful for cardiovascular events in adults 28 although the significance of this change in pediatric populations remains to be determined.…”

Section: Pre-vitd Treatmentsupporting

confidence: 89%

Improvements in peripheral vascular function with vitamin D treatment in deficient adolescents with type 1 diabetes

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Pre-vitd Treatmentsupporting

confidence: 89%

Improvements in peripheral vascular function with vitamin D treatment in deficient adolescents with type 1 diabetes

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Kitano et al [20] reported that short-term miglitol treatment in patients with postprandial hyperglycemia and recent ACS attenuated the postprandial glucose spike, accompanied by improvement of endothelial function. In addition, a previous large randomized controlled trial and a meta-analysis showed that αGI treatment could prevent the development of CV events [21, 22].…”

Section: Discussionmentioning

confidence: 99%

α-Glucosidase inhibitor miglitol attenuates glucose fluctuation, heart rate variability and sympathetic activity in patients with type 2 diabetes and acute coronary syndrome: a multicenter randomized controlled (MACS) study

Shimabukuro

Tanaka

Sata

et al. 2017

Cardiovasc Diabetol

View full text Add to dashboard Cite

BackgroundLittle is known about clinical associations between glucose fluctuations including hypoglycemia, heart rate variability (HRV), and the activity of the sympathetic nervous system (SNS) in patients with acute phase of acute coronary syndrome (ACS). This pilot study aimed to evaluate the short-term effects of glucose fluctuations on HRV and SNS activity in type 2 diabetes mellitus (T2DM) patients with recent ACS. We also examined the effect of suppressing glucose fluctuations with miglitol on these variables.MethodsThis prospective, randomized, open-label, blinded-endpoint, multicenter, parallel-group comparative study included 39 T2DM patients with recent ACS, who were randomly assigned to either a miglitol group (n = 19) or a control group (n = 20). After initial 24-h Holter electrocardiogram (ECG) (Day 1), miglitol was commenced and another 24-h Holter ECG (Day 2) was recorded. In addition, continuous glucose monitoring (CGM) was performed throughout the Holter ECG.ResultsAlthough frequent episodes of subclinical hypoglycemia (≤4.44 mmo/L) during CGM were observed on Day 1 in the both groups (35% of patients in the control group and 31% in the miglitol group), glucose fluctuations were decreased and the minimum glucose level was increased with substantial reduction in the episodes of subclinical hypoglycemia to 7.7% in the miglitol group on Day 2. Holter ECG showed that the mean and maximum heart rate and mean LF/HF were increased on Day 2 in the control group, and these increases were attenuated by miglitol. When divided 24-h time periods into day-time (0700–1800 h), night-time (1800–0000 h), and bed-time (0000–0700 h), we found increased SNS activity during day-time, increased maximum heart rate during night-time, and glucose fluctuations during bed-time, which were attenuated by miglitol treatment.ConclusionsIn T2DM patients with recent ACS, glucose fluctuations with subclinical hypoglycemia were associated with alterations of HRV and SNS activity, which were mitigated by miglitol, suggesting that these pathological relationships may be a residual therapeutic target in such patients. Trial registration Unique Trial Number, UMIN000005874 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000006929)Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-017-0571-1) contains supplementary material, which is available to authorized users.

show abstract

“…Oxidative stress and inflammation have been suggested as potential mediators that could link postprandial hyperglycemia, in part through endothelial dysfunction [ 23 - 25 ], to diabetes complications [ 26 - 28 ] although the association of greater peaks with oxidative stress remains to be clearly established [ 29 ]. Individuals with diabetes tend to exhibit high levels of adhesion molecule markers of endothelial dysfunction – ICAM-1, VCAM-1 and E-selectin [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Glucose and triglyceride excursions following a standardized meal in individuals with diabetes: ELSA-Brasil study

Riboldi

Luft

Castilhos

et al. 2015

Cardiovasc Diabetol

View full text Add to dashboard Cite

ObjectiveTo assess glucose and triglyceride excursions 2 hours after the ingestion of a standardized meal and their associations with clinical characteristics and cardiovascular complications in individuals with diabetes.Research design and methodsBlood samples of 898 subjects with diabetes were collected at fasting and 2 hours after a meal containing 455 kcal, 14 g of saturated fat and 47 g of carbohydrates. Self-reported morbidity, socio-demographic characteristics and clinical measures were obtained by interview and exams performed at the baseline visit of the ELSA-Brasil cohort study.ResultsMedian (interquartile range, IQR) for fasting glucose was 150.5 (123–198) mg/dL and for fasting triglycerides 140 (103–199) mg/dL. The median excursion for glucose was 45 (15–76) mg/dL and for triglycerides 26 (11–45) mg/dL. In multiple linear regression, a greater glucose excursion was associated with higher glycated hemoglobin (10.7, 95% CI 9.1–12.3 mg/dL), duration of diabetes (4.5; 2.6–6.4 mg/dL, per 5 year increase), insulin use (44.4; 31.7–57.1 mg/dL), and age (6.1; 2.5–9.6 mg/dL, per 10 year increase); and with lower body mass index (−5.6; −8.4– -2.8 mg/dL, per 5 kg/m2 increase). In adjusted logistic regression models, a greater glucose excursion was marginally associated with the presence of cardiovascular comorbidities (coronary heart disease, myocardial infarction and angina) in those with obesity.ConclusionsA greater postprandial glycemic response to a small meal was positively associated with indicators of a decreased capacity for insulin secretion and negatively associated with obesity. No pattern of response was observed with a greater postprandial triglyceride excursion.

show abstract

Miglitol improves postprandial endothelial dysfunction in patients with acute coronary syndrome and new-onset postprandial hyperglycemia

Cited by 18 publications

References 66 publications

Improvements in peripheral vascular function with vitamin D treatment in deficient adolescents with type 1 diabetes

Improvements in peripheral vascular function with vitamin D treatment in deficient adolescents with type 1 diabetes

α-Glucosidase inhibitor miglitol attenuates glucose fluctuation, heart rate variability and sympathetic activity in patients with type 2 diabetes and acute coronary syndrome: a multicenter randomized controlled (MACS) study

Glucose and triglyceride excursions following a standardized meal in individuals with diabetes: ELSA-Brasil study

Contact Info

Product

Resources

About